The Swedish (rear facing) car seat approach

How does Sweden keep young children so safe in cars? How come fatalities and serious injuries are close to zero for young children? This is a common question among foreigners. Ask a Swedish parent and the answer will be a shrug, parents feel like they are doing nothing special. The answer to our safety record is a very simple and affordable approach which is very effective in keeping the little ones safe in cars.

Sweden started focusing on car seat safety in 1960's, decades before other countries. We realized early on that many children were dying in traffic and that almost all of these fatalities could easily be prevented by simple and affordable mesures regardless of country. In the 1960's we also discovered how amazingly safe rear facing was, something which has saved the lives of a large amount of children since then.

Child fatalities in traffic has decreased but is even in 2010 a common reason for children dying in modern countries. Traffic accidents in USA are for example the number one cause of death among young children. Thing about that for a minute. Traffic is the largest killer of children in the country, far more common than any desease, drowning, etc. Almost all of these fatalities are easily preventable with simple and affordable measures.

Our approach is extremely simple and can basically be divided into three simple stages:

1. Infant stage – birth to around 6 months:

Children sit rear facing, normally in an infant seat. These seats are affordable and easy to use. Some parents use seats such as DuoLogic from birth which also works nicely.

2. Age 6 months to 4 years (or longer):

Children sit rear facing in our Swedish seats which provide unbelievable protection. We keep our kids rear facing mainly for the great protection of head and neck. As doctors say, "we can fix arms and legs – we can't fix head and neck". At this stage all children have weak neck muscles and a fragile skeleton. Head of a child is also proportionally very large, around 25% of total weight for a 12 month old. This makes forward facing a bad choice before age 4.

Most of our seats have rear facing weight limits of 25 kg (55 lbs) and some use 18 kg (40 lbs). The Swedish rear facing seats can be used comfortably until age 4-6 years in all positions of the car. Seats are overall compact, there are rear facing options for families with small cars as well.

Contrary to popular belief there is no law regarding rear facing use in Sweden. We use it since it's a safe and easy solution.

How safe is rear facing? Our experiences, going back to 1965, show that it's almost impossible for a child in a rear facing Swedish seat to die or become seriously injured regardless of circumstances.

3. Age 4-10 years:

Children sit forward facing in high back boosters (rear facing longer than age 4 would be far safer and preferred). A high back booster is necessary for two reasons. First, to keep seat belt across chest of child. The high back booster keeps seat belt in the right place and can be adjusted a children grow. Second, to keep the lower part of the seat belt, the lap part, below a child's abdomen.

Children have round and underdeveloped hip bones, also called iliac crest, which means seat belt will slide up on abdomen in a collision unless a booster is used. This can cause terrible internal injuries. A booster will keep seat belt low on the hips where the tremendous forces in a collision can be absorbed.

We do have parents who only use a booster cushion for their children and some who only use seat belt. The Swedes are doing a great job in keeping their kids safe in cars but there is still plenty of room for improvement.

It's easy to talk about car seat safety and theoretical approaches. How well does the Swedish approach work? Unbelievably well!!. How do we know this? We follow our own advice and our fatality rate for children age 0-6 years in traffic accidents is basically zero each year.

How come other countries don't follow our approach? Or at least try harder in lowering the amount of fatalities and serious injuries among young children? The answer is that car seat safety is a low priority in other countries despite taking the lives and seriously injuring an enormous amount of children each year.

Coming up next, some things we do and other things we avoid to keep our children safe in cars. The answers are likely to surprise you.

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Comments

I really found it hard to source a rear facing car seat, for my 9 month old, I found the knowledge in the market is really poor. I was told these seats were not availble in the UK, by a number of so called leading car seat suppliers.

I have alsways had Volvo’s or Saab’s so I was able to purchase a seat at a main dealer, although the sales knowledge was stil fairly poor in the branch,luckily I had already done my home work.
I have been sitting in the rear of the car,with my child, when we have had to break suddenly and you can clearly see the support these seats have on a childs neck.
I am really glad I took the time to research these seats and am very glad for blogs and sites like this.

I’m from Greece and in may country they dot know what is rear facing. I think the 95% of the people are using the frond facing. They ignore the benefits of using the rear facing. We have to change that situation for saving our children and we have to stop that suicide of our kids

I agree with the man from Greece
Ive been to greece and I saw kids riding with no car seats at all
It’s Crazy absolutely insane for the parents to allow that especially in a country like greece where they are known for so many automobile collisions!!!

I’ve just bought one of these seats, even though I run the risk of being prosecuted for not using a child seat that conforms to Australian Standards (which are a joke). My child’s life is more important than any government bureaucraZy.

I called Britax about the lack of rear facing seats in the UK and was disgusted with their response. They say they do not sell them here because there is no demand and the government do not say they have to. I explained that the English are not used to keeping children rear facing and that education was necessary yet they still insisted that until the government made them, they will not sell them to us (except in one shop).
I will keep my son rear facing for as long as I can. I have researched medical papers and journals and am certain that it is the best option.

This information about rear-facing longer than one year has literally just infiltrated the mainstream U.S. market and many parents are scoffing at the idea. This is great information to put out there and I agree with the above comments about the carseat companies not making the products available in other countries. We can get all of these brands here, but not all of the products! Frustrating, to say the least.

Sonia: Car seat safety is unfortunately not a priority in any country outside of Sweden. Here in Sweden we have the same laws and regulations as UK but government/organisations etc. never talk about forward facing for young children. Forward facing seas are allowed in Sweden but retailers don't sell them anywhere in Sweden since we know it's not safe.

Anna: The change of advice in US is a great step in the right direction. I would call it a baby step since advice still can be greatly improved.

" How come other countries don't follow our approach? Or at least try harder in lowering the amount of fatalities and serious injuries among young children? The answer is that car seat safety is a low priority in other countries despite taking the lives and seriously injuring an enormous amount of children each year. "
This is a very big statement. Safety is a priority in the west. Safety standards vary b country.

lilkunta: It may be a big statement but it's true. Car seat safety is not a priority in most countries. It is a priority in Sweden. Norway and Finland are doing ok. Then it's a huge drop to other countries. It's forward facing from 9-12 months and that's it. A large number of kids are also unrestrained, informationis poor and conflicting, manufacturers prioritize forward facing, etc. It's unfortunately a long list

thanks for adding the suscription button.
Again you are speaking on that which I feel you dont know. What is your source that car safety isnt a priority? It definitely IS in the UK , Canada, US. What is your source that the greatest are Swedes. Ive no problem with your nationalistic pride, but I'd like facts.

likunta: Your question is a little confusing. Everybody who works seriously with car seats know that UK, Canada and US are very far behind in car seat safety and that it's not a priority. There are many examples of this, a few below:

– The countries you listed push forward facing seats from 9-12 months. No one with a priority on car seat safety would do such a thing

– Fatalities and injuries are very high. Traffic accidents are #1 killer of young children in US

– A large percentage of children who die/injured are unrestrained

– Availability of rear facing car seats is poor or at least not good. Weight limits are low. Retailers are unhappy about selling them as well (more work, etc)

– Organisations come with poorly worded and weak recommendations regarding rear facing. 1 year and 20 lbs in US is a good example. That show car seat safety is very far down on the list

– The Swedes are well known for their unbelievable safety record for children in cars. Traffic accidents are the number one killer in US of young children. In Sweden our fatality rate is basically zero each year for ages 0-6 years.

Apologies for the confusion.
You repeat over & over that
__"it is a well known fact that uk canada us is 30yrs behind in safety compared to Sweden"__ Please give a soure for this. DId the Sweden govt commission a study?
The reason the law is being changed in the US is b/c of the research study by the University of Virgina study.
So there should be a study and research to support your statement. Or is this your opinion?
What council or governing body determined : "The Swedes are well known for their unbelievable safety record for children in cars. "._
If this is true there MUST be a study done to support this. Pleass send me a link.
I'd just like some facts.

lilkunta: Your question has already been answered above with some examples. It’s very odd you don't realize that for example US beeing very far behind regarding car seat safety. It’s nice to see that the rear facing age advice now has been changed. It’s a good step in the right direction.

In almost every article talking about car seat safety Sweden is mentioned and praised since we keep children rear facing and our young children almost never die or become seriously injured. The fantastic safety record is often mentioned and the country is seen as an example for how to protect children in cars.

One needs no council or governing body to see how countries are doing regarding car seat safety. It's very obvious by looking at habits, advice, stats, seats available and other factors.

Hi I am in the USA and my kids are all still rear facing. They are ages 5.5 years old, 4years old, and 1.5 years old. (Yes, my seats are all USA made, and thus not illegal for me to use this way here.) I get a lot of rude comments from other parents, but my children's safety is my top priority.